Blood lead levels and their associated risk factors in Chinese adults from 1980 to 2018

In China, studies on lead exposure to grownup are scarce compared to children, although relevant disease burdens for adults are much severe than that in developed countries. The present study evaluated blood lead levels (BLLs) in Chinese adults by data mining using Monte Carlo simulation. A total of 115 scientific studies published between January 1980 and March 2021 reflecting 45,514 Chinese adults were included in the study. After a continuous increase in Chinese adult BLLs from 1980-1983 (GM 74.84 μg/L) to 1994-1996 (GM 92.27 μg/L), BLLs began to decline from 2000-­2002 (GM 80.32 μg/L) to 2016-2018 (GM 21.57 μg/L). This decline implied that the lead phase-out policy in gasoline was effective over the past two decades. The study indicated that North, South, and Southwest China were still relatively high compared to other regions in the past decade. Statistical analysis showed that BLLs of males (GM 68.45 μg/L) were higher than females (GM 56.51 μg/L), smokers (GM 80.96 μg/L) higher than nonsmokers (GM 58.95 μg/L), and populations over 40 (GM 40.43 μg/L) higher than younger populations (GM 40.37 μg/L). The significantly positive correlation between the concentrations of PM2.5 and topsoil lead and BLLs in Chinese adults indicated that air and soil pollution affect adult BLLs. Taken together, our results showed that strict lead control strategies and regular bio-monitoring are needed to maintain low BLLs in the population.